• 한국병원경영학회지
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• 제25권4호
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• pp.29-37
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• 2020

Purposes: This study purposed to identify influence of postpartum care services on health-related quality of life in women after birth. Methodology: Korea Health Panel Survey 2009-2015 provided by the Korea Institute for Health and Social Affairs and National Health Insurance Service was used for the analysis. The health-related quality of life evaluate as a EuroQoL-5D(EQ-5D-3L, used the weight of the CDC) was used as dependent variables. Postpartum care services was used as independent variable. Demographic factors(education, economic activity, region, house income), health related variable(presence of chronic disease, self-rated health), birth related variable(birth-related problem, childbirth, pregnancy of advanced maternal age) used as covariates. Regression analysis was used. Findings: The rate of use of postpartum care services is increasing year by year. Postpartum care services and self-rated health positively influence on the health-related quality of life in women after birth and chronic disease and birth-related problem negatively influence on. Practical Implications: Therefore, it is necessary that the government's policy of the postpartum care service be expanded and systematized to increase accessibility on. There are rare studies on the health-related quality of life of women after childbirth, adjusted for birth-related variables. So this study has significance.

• 간호행정학회지
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• 제3권1호
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• pp.107-118
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• 1997

This study was designed to obtain basic data for development of evaluation tool which would be needed to measure the outcome of general quality nursing care of individual patient. The purpose of this study was to analyze and classify the outcome indicators of quality nursing care. The 29 articles of quality nursing care and outcome measures were selected coveniently, and analyzed to classify the outcome indicators of quality nursing care using open coding method. The results of this study were as follows: 1. Quality nursing care was defined as level of excellence of nursing care to achieve good patient outcome. 2. The 6 domains of which were health status, satisfaction, self care, patient progress and prognosis, and compliance were identified in outcome indicators of quality nursing care 3. Seven indicators of health status domain which were perceived health status, quality of life, well-being, daily activities, physical-physiological status, psychoemotional status, and social role functioning were identified. 4. Two indicators of satifaction domain which were patient satisfaction and family satisfaction were identified. 5. Three indicators of self care domain which were skill, knowledge, and home management were identified. 6. Seven indicators of patient progress and prognosis domain which were change of clinical status, resolution of nursing diagnosis and problem, days of stay, dicahrge state, recovery state, survival were identified. 7. compliance with therapeutic direction compliance was identified as an indicator of compliance domain. 8. It was sugested that studies for development of evaluation tools for outcomes of quality nursing the results of this study could be executed

• 한국의료질향상학회지
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• 제19권2호
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• pp.14-34
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• 2013

Objectives: The purpose of this study is to provide comprehensive information of qualification systems of developed countries needed to establish our national system for QI(Quality improvement) specialists. Methods: All articles related to any applicable domestic or foreign countries' laws, operational status, and detailed programs for professional qualification system of QI were reviewed. Result: In the United States, a non-profit organization, Healthcare Quality Certification Commission (HQCC) has set the policies, procedures and standards in the field of health care quality. And qualification system of CPHQ (certified professional in healthcare quality) has been operated in order to authenticate the qualifications in the field of quality management. IBQH(international Board for quality in healthcare), a qualification system of experts in the United Kingdom, was designed to assist the qualification of professionals to improve the quality of healthcare. In addition, Health Research Center of Feinberg School of Medicine in Northwestern University has been operating Master's and doctoral degree programs in the field of the quality of care and patient safety and IHI (institute for healthcare improvement) open school was operating a professional training course related to the quality of care and patient safety. Conclusion: Quantity and complexity of information of the quality of care and patient safety have been increased. For reform of the health care system, a special training course of the expertise and leadership are needed. So far, there is no national professional certification courses in our nation. Therefore essential job skill should be acquired individually. For systematic and effective quality improvement activities, the educational and certification system with professional development model are needed.

• 한국의료질향상학회지
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• 제10권2호
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• pp.266-277
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• 2003

• 한국의료질향상학회지
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• 제12권2호
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• pp.75-83
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• 2006

Background : Utilization review has been adopted as a vehicle for cost and utilization control of health care services. Its role was further stressed and expanded through the establishment of Health Insurance Review Agency in 2001. This article is to introduce concept, activities, and effect of utilization review based on the experiences of U.S. and to suggest important characteristics for ideal utilization review activities at the national level in Korea. Method : Twenty-five articles related with utilization review were reviewed after being selected through web site search through Med Line and Richis. Result : Utilization review was introduced mainly for health care expenditure control either by insurer, provider or the third parties under the pressure of increasing health care cost. It's activities can be categorized to prospective, concurrent and retrospective review according to the time of service provision. Based on most of studies, utilization review has been effective in controling rising health care cost and utilization. However it's effectiveness assumes a reimbursement structure of managed care like capitation payment. More worse, it is still unknown it's effectiveness on quality of care. Conclusion : Utilization review should be employed to increase the cost effectiveness of medical care by optimizing quality and patient's outcomes while also attempting to reduce the use of resources. So, it should consider outcomes before expenditures, check for both under and over-use, and construct an structure in which consumption is reduced equitably. Aggressive adoption of utilization review in Korean health care setting with fee-for-service reimbursement structure might not be a cost-effective approach before adoption of prospective payment system such as D.R.G. and capitation.

• 한국의료질향상학회지
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• 제16권1호
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• pp.41-51
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• 2010

• Journal of Preventive Medicine and Public Health
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• 제45권3호
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• pp.148-155
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• 2012

Since the reformation of the National Health Insurance Act in 2000, the Health Insurance Review and Assessment Service (HIRA) in the Republic of Korea has performed quality assessments for healthcare providers. The HIRA Value Incentive Program (VIP), established in July 2007, provides incentives for excellent-quality institutions and disincentives for poorquality ones. The program is implemented based on data collected between July 2007 and December 2009. The goal of the VIP is to improve the overall quality of care and decrease the quality gaps among healthcare institutions. Thus far, the VIP has targeted acute myocardial infarction (AMI) and Caesarian section (C-section) care. The incentives and disincentives awarded to the hospitals by their composite quality scores of the AMI and C-section scores. The results of the VIP showed continuous and marked improvement in the composite quality scores of the AMI and C-section measures between 2007 and 2010. With the demonstrated success of the VIP project, the Ministry of Health and Welfare expanded the program in 2011 to include general hospitals. The HIRA VIP was deemed applicable to the Korean healthcare system, but before it can be expanded further, the program must overcome several major concerns, as follows: inclusion of resource use measures, rigorous evaluation of impact, application of the VIP to the changing payment system, and expansion of the VIP to primary care clinics.

• 보건행정학회지
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• 제19권4호
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• pp.78-97
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• 2009

This study examined the factors related to family caregiver satisfaction with institutional care services for beneficiaries under the Public Long-Term Care Insurance(PLTCI) system. Determining what contributes to family caregiver satisfaction is a critical step toward implementing effective quality improvement strategies. A national cross-sectional descriptive survey was conducted from November to December 2008, using proportionate quota sampling based on the location and level of Long-Term Care of the beneficiaries. Total 1,745 family caregivers wrote informed consents and 733 (response rate 42%) completed questionnaires, which included caregiver characteristics, organizational resources, primary objective and subjective stressors, perceived quality of services, and family caregiver satisfaction. Family caregivers were satisfied overall with institutional care. In multiple regression analysis, there was a statistically significant difference in degree of family caregiver satisfaction according to caregiver characteristics(relationship to beneficiary), primary objective stressors (insurance type of beneficiary), perceived quality of services(respect to family caregivers' idea, ADL support, expertness of staff, careful concern of staff, fulfillment of client's requests, and safety of institution's environment). In public long-term care, satisfaction efforts are in an early stage of development. This study is meaningful as the first attempt to measure family caregiver satisfaction with institutional care for beneficiaries under the PLTCI system, and to identify factors affecting the satisfaction. Among the identified factors, the policy makers, the insurer, and the providers need to pay attention to perceived quality of services, in particular, to improve customer satisfaction. Our findings can provide quality care improvement initiatives in the public long-term care setting.

• 한국의료질향상학회지
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• 제13권1호
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• pp.31-36
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• 2007

• Journal of Korean Biological Nursing Science
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• 제22권3호
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• pp.192-203
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• 2020

Purpose: The purpose of this study was to identify the influencing factors of oral environment and self-care behavior on the oral health-related quality of life in the elderly with diabetes. Methods: The participants were 110 elderly patients with diabetes and follow-up care on their outpatient clinic in D and G city. Data were collected September-December 2018, using questionnaires of the Oral Health Impact Profile (OHIP-49) and Kim's Self-care Behavior, measuring with the tooth-pick (Premiers Dental), Halitosis Checker (HC-212M), and Moisture Checker for Mucus (MCM) for oral environments. The data were analyzed the by independent t-test, oneway ANOVA, Pearson's correlation, and stepwise multiple regression analysis using an IBM SPSS Statistics 25.0 Program. Results: There was positive correlation between oral health-related quality of life and self-care behavior (r= .61, p< .001), negative correlations among halitosis (r = -.34, p< .001), gingival index (r = -.31, p= .001) and plaque index (r = -.32, p= .001). Self-care behavior (β= .46, p< .001), subjective health status (good) (β= .23, p= .002), halitosis (β= -.16, p= .030), and plaque index (β= -.15, p= .041) explained 46.0% of the variance in the oral health-related quality of life. Conclusion: It is necessary to develop nursing care for elderly patients with diabetes that can enhance the self-care behavior and subjective health status, and lower halitosis and plaque index, the factors influencing the oral health-related quality of life in elderly patients with diabetes.